Faculty Opinions recommendation of Implementation of guidelines for management of possible multidrug-resistant pneumonia in intensive care: an observational, multicentre cohort study.

ObjectivesTo estimate the incidence, duration and cost of futile treatment for end-of-life hospital admissions.DesignRetrospective multicentre cohort study involving a clinical audit of hospital admissions.SettingThree Australian public-sector tertiary hospitals.ParticipantsAdult patients who died while admitted to one of the study hospitals over a 6-month period in 2012.Main outcome measuresIncidences of futile treatment among end-of-life admissions; length of stay in both ward and intensive care settings for the duration that patients received futile treatments; health system costs associated with futile treatments; monetary valuation of bed days associated with futile treatment.ResultsThe incidence rate of futile treatment in end-of-life admissions was 12.1% across the three study hospitals (range 6.0%–19.6%). For admissions involving futile treatment, the mean length of stay following the onset of futile treatment was 15 days, with 5.25 of these days in the intensive care unit. The cost associated with futile bed days was estimated to be $AA12.4 million for the three study hospitals using health system costs, and $A988 000 when using a decision maker’s willingness to pay for bed days. This was extrapolated to an annual national health system cost of $A153.1 million and a decision maker’s willingness to pay of $A12.3 million.ConclusionsThe incidence rate and cost of futile treatment in end-of-life admissions varied between hospitals. The overall impact was substantial in terms of both the bed days and cost incurred. An increased awareness of these economic costs may generate support for interventions designed to reduce futile treatments. We did not include emotional hardship or pain and suffering, which represent additional costs.

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Phosphate abnormalities and outcomes among admissions to the intensive care unit: A retrospective multicentre cohort study

Journal of Critical Care ◽

10.1016/j.jcrc.2021.03.012 ◽

2021 ◽

Author(s):

Jeremy Cheuk Kin Sin ◽

Kevin B. Laupland ◽

Mahesh Ramanan ◽

Alexis Tabah

Keyword(s):

Intensive Care Unit ◽

Cohort Study ◽

Intensive Care ◽

Multicentre Cohort Study ◽

Multicentre Cohort

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Adverse outcomes after planned surgery with anticipated intensive care admission in out-of-office-hours time periods: a multicentre cohort study

British Journal of Anaesthesia ◽

10.1016/j.bja.2018.02.063 ◽

2018 ◽

Vol 120 (6) ◽

pp. 1420-1428 ◽

Cited By ~ 6

Author(s):

D.J. Morgan ◽

K.M. Ho ◽

M.L. Kolybaba ◽

Y.J. Ong

Keyword(s):

Cohort Study ◽

Intensive Care ◽

Adverse Outcomes ◽

Intensive Care Admission ◽

Multicentre Cohort Study ◽

Time Periods ◽

Multicentre Cohort

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Functional Outcomes in Patients Admitted to the Intensive Care Unit with Traumatic Brain Injury and Exposed to Hyperoxia: A Retrospective Multicentre Cohort Study

Neurocritical Care ◽

10.1007/s12028-020-01033-y ◽

2020 ◽

Author(s):

M. Weeden ◽

M. Bailey ◽

B. Gabbe ◽

D. Pilcher ◽

R. Bellomo ◽

...

Keyword(s):

Intensive Care Unit ◽

Traumatic Brain Injury ◽

Cohort Study ◽

Intensive Care ◽

Brain Injury ◽

Functional Outcomes ◽

Multicentre Cohort Study ◽

Multicentre Cohort

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Causes of death in critically ill paediatric patients in Japan: a retrospective multicentre cohort study

BMJ Paediatrics Open ◽

10.1136/bmjpo-2019-000499 ◽

2019 ◽

Vol 3 (1) ◽

pp. e000499 ◽

Cited By ~ 3

Author(s):

Tadashi Ishihara ◽

Hiroshi Tanaka

Keyword(s):

Cohort Study ◽

Intensive Care ◽

Chronic Illness ◽

Intensive Care Units ◽

Chronic Conditions ◽

Chronic Condition ◽

Causes Of Death ◽

Paediatric Patients ◽

Multicentre Cohort Study ◽

Multicentre Cohort

ObjectivesThe primary objective is to clarify the clinical profiles of paediatric patients who died in intensive care units (ICUs) or paediatric intensive care units (PICUs), and the secondary objective is to ascertain the demographic differences between patients who died with and without chronic conditions.MethodsIn this retrospective multicentre cohort study, we collected data on paediatric death from the Japanese Registry of Pediatric Acute Care (JaRPAC) database. We included patients who were ≤16 years of age and had died in either a PICU or an ICU of a participating hospital between April 2014 and March 2017. The causes of death were compared between patients with and without chronic conditions.ResultsTwenty-three hospitals participated, and 6199 paediatric patients who were registered in the JaRPAC database were included. During the study period, 126 (2.1%) patients died (children without chronic illness, n=33; children with chronic illness, n=93). Twenty-five paediatric patients died due to an extrinsic disease, and there was a significant difference in extrinsic diseases between the two groups (children without chronic illness, 15 (45%); children with chronic illness, 10 (11%); p<0.01). Cardiovascular disease was the most common chronic condition (27/83, 29%). Eighty-three patients (85%) in the chronic group died due to an intrinsic disease, primarily congenital heart disease (14/93, 15%), followed by sepsis (13/93, 14%).ConclusionsThe majority of deaths were in children with a chronic condition. The major causes of death in children without a chronic illness were due to intrinsic factors such as cardiovascular and neuromuscular diseases, and the proportion of deaths due to extrinsic causes was higher in children without chronic illness.

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Age differences in clinical features and outcomes in patients with COVID-19, Jiangsu, China: a retrospective, multicentre cohort study

BMJ Open ◽

10.1136/bmjopen-2020-039887 ◽

2020 ◽

Vol 10 (10) ◽

pp. e039887 ◽

Cited By ~ 1

Author(s):

Huanyuan Luo ◽

Songqiao Liu ◽

Yuancheng Wang ◽

Penelope A Phillips-Howard ◽

Shenghong Ju ◽

...

Keyword(s):

Cohort Study ◽

Intensive Care ◽

Respiratory Failure ◽

Hospital Stay ◽

Older Patients ◽

Adverse Outcomes ◽

Trend Test ◽

Chronic Obstructive ◽

Multicentre Cohort Study ◽

Multicentre Cohort

ObjectivesTo determine the age-specific clinical presentations and incidence of adverse outcomes among patients with COVID-19 in Jiangsu, China.Design and settingRetrospective, multicentre cohort study performed at 24 hospitals in Jiangsu, China.Participants625 patients with COVID-19 enrolled between 10 January and 15 March 2020.ResultsOf the 625 patients (median age, 46 years; 329 (52.6%) men), 37 (5.9%) were children (18 years or younger), 261 (41.8%) young adults (19–44 years), 248 (39.7%) middle-aged adults (45–64 years) and 79 (12.6%) elderly adults (65 years or older). The incidence of hypertension, coronary heart disease, chronic obstructive pulmonary disease and diabetes comorbidities increased with age (trend test, p<0.0001, p=0.0003, p<0.0001 and p<0.0001, respectively). Fever, cough and shortness of breath occurred more commonly among older patients, especially the elderly, compared with children (χ2 test, p=0.0008, 0.0146 and 0.0282, respectively). The quadrant score and pulmonary opacity score increased with age (trend test, both p<0.0001). Older patients had many significantly different laboratory parameters from younger patients. Elderly patients had the highest proportion of severe or critically-ill cases (33.0%, χ2 test p<0.0001), intensive care unit use (35.4%, χ2 test p<0.0001), respiratory failure (31.6%, χ2 test p<0.0001) and the longest hospital stay (median 21 days, Kruskal–Wallis test p<0.0001).ConclusionsElderly (≥65 years) patients with COVID-19 had the highest risk of severe or critical illness, intensive care use, respiratory failure and the longest hospital stay, which may be due partly to their having a higher incidence of comorbidities and poor immune responses to COVID-19.

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